Validity and Reliability of an Alcohol Withdrawal Clinical Assessment Scale for Use with Acutely Ill Patients: An Abbreviated Version of the CIWA-Ar

Abstract

The number of people in the United States admitted to hospitals with alcohol use disorder is increasing. Screening for alcohol dependence is a critical component to prevent alcohol withdrawal syndrome which places both the patient and staff at risk for injury. Management of symptoms includes early identification of at-risk individuals and continuous assessment of symptoms and treatment plans. In light of the growing number of patients in need of care for alcohol disorders, our goal was to assess the reliability and validity of a more concise version of the Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar) to enhance clinical efficiency without compromising the integrity of this diagnostic instrument. Members of an interdisciplinary team researched and revised the full 10-item CIWA-Ar to six items. Clinicians were trained on how to conduct and document their diagnostic findings using this abridged 6-item instrument. The research team then examined the psychometric properties of the new brief instrument to determine reliability and validity. The research team confirmed content validity. Based on data drawn from multiple sites, we compared the 10-item version of this instrument to the 6-item version; this produced a strong positive correlation, thereby satisfying concurrent criterion validity. Correlational analysis of 71 cases confirmed robust interrater reliability. This pilot study suggests that the new 6-item scale is a valid and reliable instrument, essentially performing equivalently to the 10-item version. Our research team therefore suggests further multi-site studies to confirm our findings of this more concise diagnostic instrument.